Disclaimer: Content is for educational purposes only and has not been evaluated by the Food & Drug Administration. Statements are not intended to diagnose, treat, cure, or prevent any disease. We encourage you to consult with a healthcare professional.
We know what it’s like to be uncomfortable in your private bits between the cheeks. awful. You are not alone – while most people never talk about these intimate issues, they are shockingly common. 90% of women have had anorectal or perineal issues in their lifetime!* At Betty, we believe understanding what you are dealing with is the critical first step to your healing. As GI Joe used to say “Knowing is half the battle”, and we agree! These are some of the most common anorectal conditions and their related symptoms:
| Internal Hemorrhoid | External Hemorrhoid | Thrombosed Hemorrhoid | Anal Fissure | Anal Itching | Abscess (and Fistula) | |
|---|---|---|---|---|---|---|
| In 40 words | Swollen blood vessels deep inside the anus | Swollen blood vessels outside the anus | An external hemorrhoid that gets a blood clot | A tear/cut in the anus. | Itching in/around the anus often due to other issues on this chart. | An infected cavity often in the perianal area. A fistula is an abnormal tunnel connecting the inside of the anal canal to the perineal skin. |
| Blood | Often. | Rarely. | Only if it bursts. | Often. | No, unless you scratch too hard. | Sometimes (with pus) |
| Pain | Rarely, because these hemorrhoids are located in an area where there are few nerves that sense pain. | Sometimes. Can be mild to moderate. | Almost always. It can cause severe pain. | Almost Always. Can be severe, sharp pain during bowel movements and then prolonged, aching pain for hours after each BM | Kinda. In the form of itching. | Often. |
| Itching | Rarely | Often | Rarely | Always | Often. | |
| Swelling/Lump | No. Unless the hemorrhoid is prolapsed. | Yes. | Yes, with a blue-ish purple hue due to blood clot. | Sometimes. A fissure can cause a small, tag-like lump called a sentinel pile | No. But a related condition can cause a thickening of the skin and inflamed skin tags. | Often. |
| Looks Like | Nothing. Cannot see except in an anorectal exam or colonoscopy. | Swollen lump. | Swollen lump with a blue-ish purple hue due to blood clot. | A paper cut in the anus. | Rash, irritation. | Abnormal and often smelly discharge (pus, blood), a visible opening/small hole and/or swelling and redness |
| Otherwise Known As | The #1 reason why people get a colonoscopy (to rule out colon or anal cancer due to blood in stool//toilet). | Piles. Roids. | Why Napoleon Lost Waterloo. True story. | Why our Founder started an entire company and movement around anorectal health. | Pruritus Ani, quite literally “itchy anus” in Latin. | A common condition that can be caused by Crohn’s Disease or just bad luck from a clogged anal gland. |
When you are dealing with some sort of anorectal/perineal discomfort but you aren’t sure what, this is what we suggest might help:
- Reach out to your doctor! Usually your family physician is the best fit (unless you are already seeing a colorectal specialist). While whatever you are dealing with might be treatable at home, it’s always better to be cautious and rule out serious issues. And if you are experiencing bleeding of any kind, it is absolutely imperative that you seek medical attention.
- Don’t assume that you have issues with your hemorrhoids. While problematic hemorrhoids are the #1 reason for anorectal discomfort, there are other conditions that are commonly mistaken for hemorrhoids and require different treatment – including anal fissures.
- Take stock of your symptoms and ideally record them for a few days. That will be helpful in getting a full picture of your situation.
- Find a hand mirror or compact and take a look where the sun don’t shine. We know, we know, this can be uncomfortable for some people but you may be able to visualize something that will help you get the care you need. If you are able, take a clean finger and palpate (touch) the area. Does your skin around your anus/perineum look normal/healthy? Or is there redness, bumps, rashes or even what might look like a tear?
Most of these anorectal conditions are generally treatable, but symptoms should not be ignored, as some may require medical intervention to prevent complications. Regardless of what issue you might be dealing with while you are waiting for a doctor’s care or if you are trying to deal with it at home, there are simple things you can do to optimize your anorectal health and perhaps help you heal naturally. Learn all about what you can do to optimize your anorectal health here.
CITATIONS:
- *According to survey of 241 women
- https://pmc.ncbi.nlm.nih.gov/articles/PMC4076876/
- DOI: 10.3748/wjg.v24.i42.4821